Dietitian involvement in the neonatal intensive care unit: more is better

J Am Diet Assoc. 2005 Aug;105(8):1224-30. doi: 10.1016/j.jada.2005.05.012.


Objective: Describe the level of registered dietitian (RD) involvement in neonatal intensive care units (NICUs) and associations with NICU nutrition practices.

Design: Questionnaires were mailed to 820 NICUs in the United States with two follow-up mailings to nonresponders. Abbreviated phone surveys were conducted with a random sample of 10% of nonresponders. A nutrition care score was devised based on a sum of 10 survey questions (range 0 to 10) to summarize the intensity of reported practices.

Subjects/setting: Directors of NICUs in the United States and RDs associated with them.

Statistical analyses: Chi2, analysis of variance, Bonferroni and Duncan multiple range tests, regression.

Results: Respondents from 417 (54%) of the 772 NICUs eligible for the study provided completed questionnaires. Among NICUs responding, 76% involved RDs in care (41% employed full- or part-time RDs, 35% employed consult RDs), and 24% had no RD. NICUs with full- or part-time RDs provided fewer kilocalories and more protein parenterally, and more kilocalories and protein enterally. NICUs with less RD involvement were more likely to provide full-term infant feedings (eg, unfortified breast milk, full-term formula) to very-low-birth-weight infants. Mean nutrition care score varied with RD involvement from 4.6+/-1.7 (mean+/-standard deviation) for NICUs with a consult RD and 4.7+/-1.4 for NICUs employing no RD to 5.6+/-1.7 for NICUs with a full- or part-time RD (overall P<.001).

Conclusions: More involvement of RDs in NICUs increased the intensity of important aspects of nutrition care that may improve outcomes of very-low-birth-weight infants in NICUs. These findings highlight the importance of RDs as NICU team members.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Analysis of Variance
  • Dietetics*
  • Humans
  • Infant Food / standards*
  • Infant Nutritional Physiological Phenomena / standards*
  • Infant, Newborn
  • Infant, Very Low Birth Weight / growth & development*
  • Intensive Care Units, Neonatal / standards
  • Intensive Care Units, Neonatal / statistics & numerical data*
  • Nutritional Support
  • Statistics, Nonparametric
  • Surveys and Questionnaires
  • United States